NDLI: Magnesium sulfate with lidocaine for preventing propofol injection pain: a randomized, double-blind, placebo-controlled trial.

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Magnesium sulfate with lidocaine for preventing propofol injection pain: a randomized, double-blind, placebo-controlled trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Galgon, Richard E. Strube, Peter Heier, Jake Groth, Jeremy Wang, Sijian Schroeder, Kristopher M.
Description	Author Affiliation: Galgon RE ( Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, B6/319, Madison, WI, 53792-3272, USA, galgon@wisc.edu.)
Abstract	PURPOSE: Propofol injection pain, despite various strategies, remains common and troublesome. This study aimed to test the hypothesis that pretreatment with the combination of intravenous lidocaine and magnesium would have an additive effect on reducing propofol injection pain. METHODS: After institutional review board (IRB) approval and informed consent, we performed a prospective, double-blind, placebo-controlled, randomized trial. Subjects were randomly assigned to pretreatment with either lidocaine (50 mg), magnesium sulfate (0.25 mg), lidocaine (50 mg) plus magnesium sulfate (0.25 mg), or 0.9 % sodium chloride. Following pretreatment, propofol (50 mg) was administered, and subjects were questioned regarding injection site pain and observed for behavioral signs of pain. RESULTS: Two hundred subjects were enrolled and 158 subjects (39 placebo, 38 lidocaine, 44 magnesium sulfate, and 37 lidocaine plus magnesium sulfate) received their assigned pretreatment intervention. Intergroup baseline characteristics were similar. The proportion of subjects reporting propofol injection pain was highest in those pretreated with magnesium sulfate (57 %), followed by those pretreated with placebo (46 %), lidocaine plus magnesium sulfate (41 %), and then lidocaine (29 %; p = 0.011). When adjusted for age, gender, diabetes mellitus, chronic pain, tobacco use, and selective-serotonin reuptake inhibitor use, the pain response scale scores were significantly reduced by lidocaine pretreatment compared to magnesium sulfate and placebo (p = 0.031 and p = 0.0003, respectively). CONCLUSIONS: In this double-blind, placebo-controlled, randomized trial, the combination of intravenous magnesium sulfate and lidocaine offered no additional benefit for the relief of propofol injection pain compared to intravenous lidocaine alone. An improved, receptor-based understanding of the mechanism of propofol injection pain is still needed.
File Format	HTM / HTML
ISSN	09138668
e-ISSN	14388359
DOI	10.1007/s00540-014-1892-9
Journal	Journal of Anesthesia
Issue Number	2
Volume Number	29
Language	English
Publisher	Springer
Publisher Date	2015-04-01
Publisher Place	Japan
Access Restriction	Open
Subject Keyword	Discipline Anesthesiology Anesthesia, Intravenous Adverse Effects Anesthetics, Intravenous Anesthetics, Local Therapeutic Use Injections, Intravenous Lidocaine Magnesium Sulfate Pain Etiology Prevention & Control Propofol Administration & Dosage Double-blind Method Drug Combinations Pain Measurement Drug Effects Randomized Controlled Trial Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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